Elevated Liver Enzymes

[Hsiao]

Hi,

On the last treatment (FEC x 6), the oncologist decided to reduce the dose of the E(Eperubicin) from 75mg/m2 to 50mg/m2 because of elevated liver enzymes.(AST= 57, ALT = 79).

Is it worth it and is it going to compromise the efficiency of my treatment?

[Hsiao]

Hi,

thanks for the answer.

I might have to delay the chemo If I monitor my liver enzymes until it gets back to normal.

What is usually the best: reduce the dose or delayed until a full dose is possible?

[PaulMD]

Hi there.

The elevation in liver enzymes would reflect some inability of the liver to detoxify and eliminate drugs like epirubicin.  For this reason, it is recommended that the dose of the drug be reduced, or changed to a different drug which does not need the liver for elimination.  I would agree with you that this reduction in dose might lead to less clinical benefits, but I believe the choices are rather limited (if this drug is changed or removed altogether, the overall efficacy of the regimen is further compromised).

I would suggest that you continue monitoring the liver enzymes, and resume to a full dose once these normalize.

Regards.